For Bills in Congress, How Long is Long?

As soon as Senate Democrats released their health care reform bill, Republicans began calling it out on its length. It’s “longer than Russian novelist Leo Tolstoy’s War and Peace,” said Sen. Orrin Hatch [R, UT] last week at a press conference set up by Senate Republicans to slam the bill.

The size of the bills has become a common talking point for opponents of health care reform. Congressional Republicans have repeatedly referenced the number of pages in the Democrats’ health care bills to try to link them to big government and excessive spending. They’ve even staged antics, like the one pictured at right of Rep. Pete Hoekstra [R, MI-2] and the House bill spread along the Capitol steps.

The AP reported recently that, counter to Senator Hatch’s claims, the Senate health care bill is not actually longer than War and Peace. Tolstoy’s novel is about twice as long as the bill. But on his broader point that the bill is extremely long, Hatch is right.

OpenCongress Research Assistant Andrew Rabinowitz downloaded bulk data and analyzed legislation from the last five sessions of Congress to determine “how long is long?” for congressional legislation and how the current health care bills compare to other long bills. Because differences in styling and formatting make page numbers an unreliable metric, he used word counts to compare the bills.

Andrew found that the Democrats’ health care bills in the Senate and the House are, comparatively, very long. In fact, at 314,900 words, the House version is the longest bill to move through Congress since at least 1999. It is more than one hundred times longer than the average bill in Congress over the last five sessions (3,105 words is the average length). For perspective, a good typist could write up the House health care bill in a little less than 65 hours at 80 WPM. If you were willing to sacrifice some comprehension you could probably skim the bill in about 8½ hours at 600 WPM.

But long bills are written by both Democrats and Republicans. The second longest bill to appear in Congress over the past ten years was authored by Republican Rep. Don Young [R, AK-1]. It’s a mere 68 words shorter than the House health care bill. Of the 10 longest bills in the past ten years, five were written by Democrats and five were written by Republicans.

Below is a list of the ten longest bills in Congress, by word count, over the last ten years:

Health Care Reform and Mammogram Guidelines

When the U.S. Preventive Services Task Force issued recommendations last week that women start screening for breast cancer at age 50, not 40, and that women above 50 get screening less frequently, congressional Republicans were quick to use it to bolster their argument against the Democrats’ health care reform legislation. “This is how rationing starts,” Sen. Jon Kyl [R, AZ], the second ranking Republican in the Senate, said during a press conference. “This is what we’re going to expect in the future,” he added. Igor Volsky at the Wonk Room documents a similar and more overt claim from Sen. John Barrasso [R, WY].

Democrats have dismissed the charges. “Let’s be clear: the task force’s recommendation will have absolutely no impact on the bills we in the Senate write, debate or vote on,” Majority Leader Harry Reid [D, NV] said in a press release. “Secretary Sebelius has also assured me there that nothing in Medicare or Medicaid will change as a result of the recommendation, and that’s the way it should be.”

The fact of the matter is that the Democrats’ health care bills are somewhat vague on the extent to which the task force’s guidelines could affect insurance coverage of mammograms. Both the Senate and House health care bills contain new consumer protections and minimum standards for health care plans including things like hospitalization, prescription drugs, maternity care and mental health coverage. But they both also include this language that would require health plans to cover U.S. Preventive Services Task Force recommendations that are rated either A or B. The task force’s recommendation that women between the age of 50 and 74 get mammograms every other year rather than the previous recommendation that they get them annually, is rated B.

Here are links to the exact section of text regarding coverage of task force recommendations rated A or B in the House bill and in the Senate bill.

To be clear, neither of the Democrats’ bills would require health insurance plans to cover mammograms for women aged 50 to 74 only every two years. The bills’ guidelines establish floors for minimum service coverage that insurers could go beyond if they so choose. In that respect, the bills are an improvement to the status quo with no requirements for minimum mammogram coverage. On the other hand, there is some concern that mandating the minimum coverage level would result in some insurers that are currently in compliance with the current recommendations of annual mammograms to scale back their coverage.

Interestingly, there is a stand-alone bill in Congress that was introduced in February that basically predicted this whole issue. The bill — known as the Mammogram and MRI Availability Act of 2009 — would require any plan that covers mammograms at all to cover them annually for women aged 40 and older. It would also require coverage of annual magnetic resonance imaging for women with genetic mutations making put that at high risk for breast cancer. The bill was introduced by Rep. Jerry Nadler [D, NY-8] and so far has not advanced in the committee process. To date, it has attracted 79 co-sponsors, all Democrats. SO far, there’s been no indication that it will be rolled into the broader health care bills.

Senate Votes to Move the Health Care Debate Forward

After 23 hours of debate, the Senate on Saturday evening voted to begin a formal debate of the Democrats’ health care reform bill. The vote, which was on a motion to end a Republican filibuster of bringing the bill to the floor, was approved with no votes to spare.

The motion required a three-fifths majority, or 60 votes, to pass, which is exactly the number of seats Democrats hold in the Senate. With no Republicans voting in favor, Democrats had to hold their every member of their caucus together. The Democrats are notoriously bad at maintaining the party line, and a handful of moderates in the party are have already said they will join a Republican filibuster later on if the bill is not significantly altered. But somehow they pulled it off. It’s a significant victory for Majority Leader Harry Reid [D, NV] and the Obama Administration, but it does not mean that they will ultimately be able to pass the bill.

Read, comment and link to the Senate health care bill on OpenCongress: Patient Protection and Affordable Care Act>>

The Democrats’ health care bill has been estimated by the Congressional Budget Office to cost $848 billion and reduce the deficit by $130 over a ten year period. It would expand health coverage to 31 million uninsured Americans. Three to four million of the newly insured individuals would be covered by a new government-run insurance plan (a.k.a the public option). The bill would require all individuals to have health insurance, and provides $447 billion to help low and moderate-income people afford plans. It would also ban many of the most egregious health industry practices, like dropping patients that get sick and denying coverage based on pre-existing conditions.

Passage of tonight’s vote was secured earlier in the day when two crucial centrist Democrats — Lincoln of Arkansas and Landrieu of Louisiana — announced that they would vote to bring the bill the bill to the floor. But both reiterated their objections to the public option included in the bill. “I am opposed to a new government administered public health care plan as a part of comprehensive health care reform, and I will not vote in favor of the proposal that has been introduced by Leader Reid as it is written,”

Sen. Lincoln said on the Senate floor. Senator Landrieu expressed a similar sentiment. “My vote today to move forward on this important debate should in no way be construed by the supporters of this current framework as an indication of how I might vote as this debate comes to an end,” she said.

When the Senate returns from Thanksgiving recess on November 30th they will take up their health care reform bill as a substitute amendment to an unrelated House bill, H.R. 3590. In order to begin the amendment process, they will have to vote to break another Republican filibuster of adopting the substitute amendment. The Democrats will need 60 votes for that, but tonight’s vote indicates that the votes will be there.

The amendment process could drag on for weeks. Dozens of amendments from both parties will be voted on, and most of them will be filibustered and require 60 votes. Senate Democrats are hoping to have a vote on final passage of the health care bill before they leave for Christmas break, but that timeline is likely to slip into 2010.

“The battle has just begun,” declared Senate Minority Leader Mitch McConnell [R, KY] on Saturday afternoon.

If and when the Senate approves a health care bill, it will go to a conference committee to be reconciled with the version passed by the House. The final version that the conference committee — known as “report” — produces will have to be approved once again by both the Senate and the House before it can be sent to President Obama to be signed into law. The conference committee report will not be open to more amendments, but it will be subject to a filibuster in the Senate and require 60 votes for passage.

Dems Secure 60 Votes To Start Debate on Health Care

The NYTimes reports: Senate Democrats said they had clinched the votes needed on Saturday to propel major health care legislation to the floor for weeks of full debate, as the majority party’s two last holdouts said that they would not block consideration of President Obama’s top domestic initiative.

Breaking news coverage: The Hill, WaPo, WSJ… more to come.

Brian Beutler is in the Capitol live-blogging the proceedings for TPM-DC: “Lincoln Voting For Debate, Still Opposes Public Option”. (That would be Sen. Blanche Lincoln [D-AR].)

Here are some tools for you to learn more and get engaged with the Patient Protection and Affordable Care Act:

• Read, comment and link to the Senate health care bill. Scroll over any section of the 2,074-page text to leave an inline comment or create a custom permalink.
• Compare the Senate health care bill to the House bill (From NYT). Click in the left-hand column to compare major features.
• See the topline numbers. Read about the Congressional Budget Office’s score of the bill on spending, deficit reduction, coverage and more. Compare the CBO Score to other versions of health care reform legislation.

More details on the OpenCongress Blog and Twitter. As you can imagine, we’ll be covering the health care debate intensively over the weeks to come, so subscribe to our blog’s RSS feed to keep up with the latest developments.

Saturday's Health Care Vote Does Not Ensure Passage

Senate Republicans today are pointing to a new CRS report to bolster their argument that a vote tomorrow to begin debate of the health care bill is a de facto vote in favor of passing the bill. According to Roll Call the report found that between 1999 and 2008, the Senate voted 41 times to approve cloture motions to begin debate of bills (the same kind of motion that will be voted on tomorrow), and of those 41 bills, 40 of them ultimately ended up being passed. That’s a 97.6 percent success rate for bills that are brought up through invoking cloture on the motion to proceed.

“Tomorrow’s vote is a critical vote because it will basically mean that we’re on the road to passage,” Sen. Judd Gregg [R,NH] said today on the Senate floor.

But here’s the thing: the vast majority of the 41 bills in the CRS report were not actually controversial. It takes only one senator to object to beginning debate of a bill and force the Senate to take a cloture vote. So often a single senator will force a cloture vote on the motion to proceed to a bill that is actually very popular and bipartisan. For example, the most recent vote the Senate took on a motion to invoke cloture on a motion to proceed to debate was on an unemployment benefits extension bill that ultimately ended up passing 98-0. Before that bill, the second most recent bill to face a cloture vote on the motion to proceed was the GIVE Act, which ended up passing on an overwhelming bipartisan vote of 79-19. Before that it was the Omnibus Public Land Management Act, which ultimately passed 77-20. Et cetera…

If you were to look at just highly controversial bills like the health care bill, the CRS report would look much less like a foregone conclusion. This isn’t scientific, and the CRS report hasn’t been made public, but the only bill in recent memory that was similarly contentious but passed the cloture motion to begin debate is the comprehensive immigration reform bill that the Senate debated during the last session of Congress. That bill ultimately failed. The Senate spent weeks voting on amendments from both sides of the aisle to try to find some kind of agreement on the bill, but in the end it failed to pass cloture on ending the debate by a vote of 45-50. Read the OpenCongress Wiki page on the bill for a good outline of the action on the bill that finally resulted in failure.

Senate Democratic leaders have been telling on-the-fence Democrats that they should vote to move the bill forward to debate because they will have opportunities on the floor to change the bill, and if they still don’t like it, they can vote it down on the cloture motion before final passage. The immigration debate of last session tells us that for bills that are this controversial, that is in fact a realistic outcome. Tomorrow’s vote is essential for passing the bill, but it does not by any means ensure final passage.

For more background on the procedure the Senate is using to bring the health care bill to the floor, see this previous blog post.